The Five-Center Study


RATIONALE: In the late 1970s, the National Cancer Institute (NCI) commissioned the Five-Center Study, the first study to follow large numbers of childhood cancer survivors into their reproductive years. About 2,500 cancer survivors and 3,400 of their siblings as controls were interviewed, representing the first wave of survivors to be successfully treated with the (then) new combination chemotherapy and radiotherapy, that has since become standard. Because this group was the first wave of survivors the cohort underrepresented those cancers that occurred in early childhood, principally leukemia, where a longer time interval was needed to reach adulthood.

CHARACTERISTICS: Adult survivors were recruited from five centers in the United States: MD Anderson Cancer Hospital in Houston, Iowa, California and Kansas. Survivors had to be diagnosed at one of these centers with a histologically diagnosed malignant neoplasm between January 1, 1945 and December 31, 1975. An exception was made for survivors of brain tumors, who could have had either a benign or a malignant tumor. They had to have survived for at least 5 years from diagnosis, though they did not have to be alive at the time of the study. They had to be aged less than 20 years at the time of diagnosis and at least 21 years old by December 31, 1979.

Data from survivors or their nearest-relative proxies was collected by interview [PDF, 1.2MB] according to a standard protocol. Most interviews were done in person (face-to-face) and in English. Medical records were abstracted for verification of cancer, deaths, fertility treatments, birth defects and cancer in the offspring.

A control group was drawn from among the siblings of the survivors, who were matched on full blood relationship, sex and date of birth in that order. To be eligible, siblings had to be aged 19 years of age or older by December 31, 1979. Siblings were selected from among the family members identified at interview by the survivor and interviewed using the same instrument. Relevant abstracts were made for the siblings’ medical records.

These methods resulted in recruitment of 2498 survivors and 3504 survivors.

Selected publications: